Stress analysis in maxillary all-on-four model / Análisis del estrés en un modelo maxilar del concepto all-on-four

The aim of this research was to evaluate the load distribution in tilted distal implants used in the all-on-four system. Two implant schemes were used. In both, two vertical anterior implants and tilted posterior implants were installed, one group with an angulation of 15 and another with an angulation of 35. The implants were installed together with a bar binding them all in a photoelastic model obtained from a replica of an edentulous maxilla. In this model, loads were produced in the sector of the bar cantilever, the abutment of the tilted implants and over the four implants using devices specially designed for this purpose. The bands were recorded with a digital camera, and the qualitative and quantitative analyses were carried out by means of student's t-test and the Mann-Whitney test in Biostat v. 5.0, considering a level of p<0.05 to establish a statistically significant relation. In the qualitative analysis, the implant with 35 presented the greatest amount of stress on the cantilever forces at cervical level. The quantitative studies showed fewer differences in all aspects assessed, although significant differences were observed between the two systems when loads were applied at cantilever level. It can be concluded that there are minimal differences in the stress distribution when comparing implants with angulations of 15 or 35. However, there is a greater concentration of stress at the cervical level in implants tilted to 35.

El objetivo de esta investigación fue evaluar la distribución de cargas en implantes angulados distales utilizados en el sistema "All-On-Four". Dos esquemas de implantes fueron empleados. En ambos, dos implantes verticales en el área anterior y dos implantes angulados en el sector posterior fueron instalados, utilizando angulaciones de 15 y 35 o en estos últimos. Los implantes fueron instalados de forma conjunta mediante una barra unida al sistema de resina fotoelástica obtenida de una replica de una maxila edéntula. En este modelo, las cargas fueron producidas en el sector del cantiléver de la barra, el pilar del implante angulado y, mediante un sistema genérico, sobre la totalidad de los implantes. Las bandas de estrés fueron reconocidas en una cámara digital donde los análisis cualitativos y cuantitativos fueron realizados utilizando las pruebas t de Student y Mann-Whitney en el programa computacional Biostat v. 5.0, considerando un valor de p<0,05 para establecer diferencias significativas. En el análisis cualitativo, los implantes con 35 presentaron una gran cantidad de estrés en el área de cantiléver, principalmente a nivel cervical. Los estudios cuantitativos mostraron limitadas diferencias en todos los aspectos, aunque diferencias significativas fueron alcanzadas cuando se compararon ambos sistemas después de la carga a nivel del cantiléver. Se puede concluir que hay diferencias menores en la distribución de estrés cuando se comparan implantes dentales con angulación de 15 y 35. Sin embargo, existe una mayor cantidad de concentraciones de estrés a nivel cervical en los implantes con 35 de angulación.

Macro design effects on stress distribution around implants: A photoelastic stress analysis.

Objectives: Biomechanics is one of the main factors for achieving long-term success of implant supported prostheses. Long-term failures mostly depend on biomechanical complications. It is important to distinguish the effects of macro design of the implants. Materials and Methods: In this study, the photoelastic response of four different types of implants that were inserted with different angulations were comparatively analyzed. The implant types investigated were screw cylinder (ITI, Straumann AG, Basel, Switzerland), stepped cylinder (Frialit2, Friadent GmbH, Manheim, Germany), root form (Camlog Rootline, Alatatec, Wilshelm, Germany), and cylindrical implant, with micro-threads on the implant neck (Astra, AstraTech, Mölndal, Sweden). In the test models, one of the implants was inserted straight, while the other one was aligned mesially with 15° angles. The superstructures were prepared as single crowns. A 150N loading was applied to the restorations throughout the test. Results: A comparison of the implant designs showed that there were no significant differences between the straight implants; however, between the inclined implants, the most favorable stress distribution was seen with the stepped cylinder implants. The least favorable stress concentration was observed around the root formed implants. Microthreads around the implant neck appeared to be effective in a homogenous stress distribution. Observations showed that misaligned implants caused less stress than straight implants, but the stress concentrations were not homogenous. Conclusion: As there were observable differences between the implant types, straight placed cylindrical implants showed better stress distribution characteristics, while inclined tapering implants had better stress distribution characteristics.

Photoelastic stress analysis of implants according to fixture design / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i, and Bicon implant system). MATERIAL AND METHOD: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine . For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit fixed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb, 30 lb). CONCLUSION: The results were as follows; 1. Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system, while the other side of 3i system tended to concentrate the stress in some parts.

Photoelastic stress analysis of implants according to fixture design / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i, and Bicon implant system). MATERIAL AND METHOD: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine . For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit fixed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb, 30 lb). CONCLUSION: The results were as follows; 1. Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system, while the other side of 3i system tended to concentrate the stress in some parts.

Photoelastic stress analysis of implant supported fixed prostheses with different placement configurations in mandibular posterior region / 대한치과보철학회지

STATEMENT OF PROBLEM: More than 70% of patients who need the implant supported restoration are parially edentulous. The principles of design for implant supported fixed partial denture in mandibular posterior region are many and varied. Jurisdiction for their use is usually based on clinical evaluation. There are several areas of interest regarding the design of implant supported fixed partial denture in mandibular posterior region. 1) Straight and tripod configuration in implant placement, 2) Two restoration types such as individualized and splinted restorations. PURPOSE: The purpose of this study was to compare the amount and distribution of stress around the implant fixtures placed in the mandibular posterior region with two different arrangements and to evaluate the effects of splinting using the photoelastic stress analysis. MATERIALS AND METHODS: 1) Production of study model: Mandibular partially edentulous model was waxed-up and duplicated with silicone and two models were poured in stone. 2) Fixture installation and photoelastic model construction: Using surveyor(Ney, USA), 3 fixtures(two 4.0x13 mm, one 5.0x10 mm, Lifecore, USA) were installed in straight and tripod configurations. Silicone molds were made and poured in photoelastic resin (PL-2. Measurements group, USA). 3) Prostheses construction: Four 3-unit bridges (Type III gold alloy, Dongmyung co., Korea) were produced with nonhexed and hexed UCLA abutments and fitted with conventional methods. The abutments were tightened with 30 Ncm torque and the static loads were applied at 12 points of the occlusal surface. 4) Photoelastic stress analysis: The polarizer analyzer system with digital camera(S-2 Pro, Fujifilm, Japan) was used to take the photoelastic fringes and analysed using computer analysis program. RESULTS: Solitary hexed UCLA restoration developed different stress patterns between two implant arrangement configurations, but there were no stress transfer to adjacent implants from the loaded implant in both configurations. However splinted restorations showed lesser amount of stresses in the loaded implants and showed stress transfer to adjacent implants in both configurations. Solitary hexed UCLA restoration with tripod configuration developed higher stresses in anterior and middle implants under loading than implants with straight configurations. Splintied 3 unit fixed partial dentures with tripod configuration showed higher stress development in posterior implant under loading but there were no obvious differences between two configurations. CONCLUSIONS: The tripod configuration of implant arrangement didn't show any advantages over the straight configuration. Splinting of 3 unit bridges with nonhexed UCLA abutments showed less stress development around the fixtures. Solitary hexed UCLA restoration developed tilting of implant fixture under offset loads.

A photoelastic stress analysis of fixed partial dentures with bicon implants on mandibular posterior area / 대한치과보철학회지

STATEMENT OF PROBLEM: Several prosthetic options are available for the restoration of multiple adjacent implants. A passively fitting prosthesis has been considered a prerequisite for the success and maintenance of osseointegration. Passivity is a particular concern with multiple implants because of documented inaccuracies in the casting and soldering process. One way to avoid this problem is to restore the implants individually, however, the restorations of individual adjacent impants requires careful adjustment of interproximal contacts. PURPOSE: The purpose of this study was to compare the stress distribution pattern and amount surrounding Bicon implants with individual crowns and splinted restorations. MATERIAL AND METHOD: A photoelastic model of a human partially edentulous left mandible with 3 Bicon implants(4*1 mm) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 abutments (4.0*6.5 mm, 0 degree, 2.0 mm post, Bicon Inc., Boston, USA) After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal (8 micrometershim stock drags without tearing), medium(40 micrometer), and heavy(80 micrometer). Splinted 3-unit fixed partial dentures were fabricated and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions(7.5, 15, 30 lb) were analyzed with a circular polaricope. RESULTS: 1. Stresses were distributed around the entire body of fin in Bicon implants. 2. Splinted restorations were useful for distribution of stress around implants especially with higher loads. 3. By increasing the contact tightness between the individually restored three implants, the stress increased in the coronal portion of implants. CONCLUSIONS: Ideal adjustment of the contact tightness was important to reduce the stresses around individually restored Bicon implants.

A photoelastic stress analysis of fixed partial dentures with endopore implants according to splinting, contact tightness, and crown length / 대한치과보철학회지

STATEMENT OF PROBLEM: A difficulty in achieving a passive-fitting prosthesis can be overcome by individual crown restoation of multiple implants. But individualized crown has another difficulty in control of contact tightness and stress distribution. PURPOSE: This in vitro study is to evaluate the stress distribution and the magnitude in the supporting tissues around Endopore implants with different crown lengths, interproximal contact tightness, and the splinting effects. MATERIAL & METHODS: Three Endopore implants(4.1*9 mm) were placed in the mandibular posterior edentulous area distal to the canine and photoelastic model was made with PL-2 resin(Measurements Group, Raleigh, USA). Restorations were fabricated in two crown lengths: 9, 13 mm. For non-splinted restorations, individual crowns were fabricated on three custom-milled titanium abutments. After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal(8 micrometershim stock drags without tearing), medium(40 micrometer), and heavy(80 micrometer). For splinted restorations, 3-unit fixed partial dentures were fabricated. This study was examined under simulated non-loaded and loaded conditions(6.8 kg). Photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure. RESULTS: 1. When restorations were not splinted, the more interproximal contact tightness was increased among the three implants, the more stress was shown in the cervical region of each implant. When crown length was increased, stresses tended to increase in the apex of implants but there were little differences in stress fringes. 2. When nonsplinted restorations were loaded on the first or third implant, stresses were increased in the apex and cervical region of loaded implant. Regardless of interproximal contact tightness level, stresses were not distributed among the three implants. But with tighter interproximal contact, stresses were increased in the cervical region of loaded first or third implant. 3. When the nonsplinted restorations were not loaded, there were little stresses on the supporting structure of implants, but low level stresses were shown in the splinted restorations even after sectioning and soldering. 4. With splinted restorations, there were little differences in stresses between different crown lengths. When splinted restorations were loaded, stresses were increased slightly on the loaded implant, but relatively even stress distribution occurred among the three implants. CONCLUSIONS: Splinting the crowns of adjacent implants is recommended for Endopore implants under the overloading situation.

Effect Of Anchorage Systems On Load Transfer With Mandibular Implant Overdentures: A Three-Dimensional Photoelastic Stress Analysis / 대한치과보철학회지

Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study. 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows; type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems, more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread,selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

Photoelastic evaluation of mandibular posterior crossbite appliance / 대한치과교정학회지

This study was undertaken to demonstrate the forces in the mandibular alveolar bone generated by activation of the mandibular posterior crossbite appliance in the treatment of buccal crossbite caused by lingual eruption of mandibular second molar. A three-dimensional photoelastic model was fabricated using a photoelastic material ( PL-3 ) to simulate alveolar bone. We observed the model from the anterior to the posterior view in a circular polariscope and recorded photographically before and after activation of the mandibular posterior crossbite appliance. The following results were obtained : 1. When the traction force was applied on the buccal surface of the mandibular second molar, stress was concentrated at the lingual alveolar crest and root apex area. The axis of rotation also was at the middle third of the buccal root surface and the root apex, so that uncontrolled tipping and a buccal traction force for the mandibular second molar were developed. 2. When the traction force was applied on the lingual surface of the mandibular second molar, more stress was observed as opposed to those situations in which the force application was on the buccal surface. In addition, stress intensity was increased below the root areas and the axis of rotation of the mandibular second molar was lost. In result, controlled tipping and intrusive tooth movements were developed. 3. When the traction force was applied on either buccal or lingual surface of the second molar, the color patterns of the anchorage unit were similar to the initial color pattern of that before the force application. So we can use the lingual arch for effective anchorage in correcting the posterior buccal crossbite. As in above mentioned results, we must avoid the rotation and uncontrolled tipping, creating occlusal interference of the malpositioned mandibular second molar when correcting posterior buccal crossbite. For this purpose, we recommend the lingual traction force on the second molar as opposed to the buccal traction.

Photoelastic evaluation of maxillary posterior crossbite appliance / 대한치과교정학회지

This study was undertaken to demonstrate the forces in the maxillary alveolar bone generated by the activation of the maxillary posterior crossbite appliance in the treatment of posterior buccal crossbite caused by buccal ectopic eruption of the maxillary second molar. A photoelastic model was fabricated using a photoelastic material ( PL-3 ) to simulate alveolar bone and ivory-colored resin teeth. The model was observed throughout the anterior and posterior view in a circular polariscope and recorded photographically before and after activation of the maxillary posterior crossbite appliance. The following conclusions were reached from this investigation : 1. When the traction force was applied on the palatal surface of the second molar, stresses were concentrated at the buccal and palatal root apices and alveolar crest area. The axis of rotation of palatal root was at the root apex and that of the buccal root was at the root 1/4 area. In this result, palatal tipping and rotating force were generated. 2. When the traction force was applied on the buccal surface of the second molar, more stresses than loading on the palatal surface were observed in the palatal and buccal root apices. Furthermore, the heavier stresses creating an intrusive force and controlled tipping force were recorded below the buccal and palatal root apices below the palatal root surface. In addition, the axis of rotation of palatal root disappeared whereas the rotation axis of the buccal root moved to the root apex from the apical 1/4 area. 3. When the traction force was simultaneously applied on the maxillary right and left second molars, the stress intensity around the maxillary first molar root area was greater than the stress generated by the only buccal traction of the maxillary right or left second molar. As in above mentioned results, we should realize that force application on the palatal surface of second molars with the maxillary posterior crossbite appliance produced rotation of the second molar and palatal traction, which may cause occlusal interference. That is to say, we have to escape the rotation and uncontrolled tipping creating occlusal interference when correcting buccal posterior crossbite. For this purpose, we recommend buccal traction rather than palatal traction force on the second molar.

A photoelastic study on the stress distribution in bone by the transpalatal lingual arch / 대한치과교정학회지

The purpose of this study was to investigate the stress distribution and intensity derived from the transpalatal lingual arch in the investing bone composed of photoelastic material(PL-3). The transpalatal lingual arch wire was deflected in the horizontal and vertical direction to give the various conditions. The two-dimensional photoelastic stress analysis was performed, and the stress distrebution was recored by photofraphy. The results were as follows: 1. In bilateral expansion, as horizontal deflection was singly applied, the stress was more concentrated on the root apex in square free end than round. In square free end, as vertical deflection was increased gradually, the black line meaning center of rotation moced inferiorly togerher with the increment of whole fringes. 2. In application of vertical deflection on anchorage side for unilateral expansion, the stress distribution that expansive force leaned to expansion side was observed. As vertical deflection increased, the extruding stress was obesrved on molar of expansion side. And as horisontal deflection increased, the tipping stress on the molar of anchorage side was observed. 3. In unilateral rotation with the asymmetric toe-in, the fringe appeared on the distal aspect of root apex.